NEW YORK (Reuters Health) - For a physically demanding job
like firefighting, fitness is a basic requirement and may
protect against injury, U.S. researchers say.

After tracking men and women in the Tucson, Arizona, fire
department for five years, the study team found firefighters
with the highest aerobic capacity tended to have the fewest
work-related sprains, strains and other injuries.

Even though the least fit firefighters were in better shape
than the general population, the study shows "those that are
'less fit' in an otherwise fairly fit population of firefighters
and medics are still susceptible to an increased risk of injury
as compared to their 'more fit' counterparts," according to lead
author Dr. Gerald S. Poplin, of the University of Virginia.

Poplin and his co-authors used aerobic capacity - the
ability of the body to use oxygen - as a gauge of firefighters
overall fitness levels. They got fitness information from
records of the fire fighters' annual physicals and tracked
injuries in fire department reports covering 2005 through 2009.

Among 799 male and female fire service employees included in
the study, 357 had at least one reported injury during the study
period. There were a total of 773 injuries - not including
strokes, heart attack, heat exhaustion and other conditions that
suggest an underlying disease or problem.

Two thirds of all work-related and exercise-related injuries
were sprains and strains. Thirty percent of injuries led to lost
time on the job.

Poplin's team followed standards from the Wellness Fitness
Initiative of the International Association of Fire Fighters
(IAFF) and the International Association of Fire Chiefs (IAFC)
to divide participants according to fitness level.

They used a measure of aerobic fitness, VO2 max, that
represents maximum oxygen levels transported through the body
during extreme exertion in the form of milliliters of oxygen per
kilogram of body weight per minute.

To put things in perspective, Poplin told Reuters Health,
for non fire-service workers, gardening may require 14ml/kg/min
of aerobic capacity, whereas professional basketball or
cross-country skiing may require more than 50ml/kg/min of
aerobic capacity.

In the general population of nonathletes, the average
healthy man will have a maximum capacity between about 35 and 40
and for the average healthy woman it will be about 27 to 31.

For the firefighters, an aerobic capacity of less than 43
was considered "less fit" and those with a capacity greater than
48 were considered "more fit." Overall fitness levels among the
study participants ranged from about 43.6 to 55.8, the
researchers report in the American Journal of Epidemiology.

In general, the firefighters' risk of on-the-job injury
increased as their fitness levels decreased. The least
physically fit firefighters were more than twice as likely to
experience injury as the fittest

The least physically fit individuals also experienced injury
sooner, within about two years, than the most physically fit
firefighters, who lasted about four years without injury.

In their report, Poplin's team says it's not clear why the
fittest firefighters were less likely to get hurt, but they
speculate that those "in the top levels of a fitness spectrum
may not be as susceptible to microtraumas and may recover better
from injury than their less-fit counterparts."

The researchers conclude, "These findings illustrate the
importance of fitness in reducing the risk of injury in
physically demanding occupations, such as the fire service, and
support the need to provide dedicated resources for structured
fitness programming and the promotion of injury prevention
strategies to people in those fields."

Jim Brinkley, director of Occupational Health and Safety for
the International Association of Fire Fighters agreed and also
emphasized the importance of teaching proper lifting and bending
techniques.

"Fitness without proper movement patterns or proper movement
without fitness both leave you unprepared to meet the physical
demands of the job," he told Reuters Health.

According to Poplin, the study results indicate that for an
individual firefighter, improving aerobic capacity by 3.5
ml/kg/minute would reduce injury risk by about 14 percent.

However, improving physical fitness among firefighters will
require financial resources and specialized trainers, such as
the peer fitness trainers used in the Wellness Fitness
Initiative, he said.

A key aspect of the initiative, which calls for
individualized wellness-fitness programs for active
firefighters, is a holistic wellness approach that addresses
"medical, fitness, injury/fitness/medical rehabilitation and
behavioral health," according to the IAFF Website.

Currently only about 10 states, including Washington, Texas,
and New York, have fire departments participating in the
initiative, along with one department in Alberta, Canada.

"We have this make-believe image that firefighters and
paramedics know how to keep themselves in shape... but they need
proper instruction just like everyone else," Poplin said.

Noting that "a lot of fire departments rely on other fire
departments," Poplin added that volunteer firefighters would
also greatly benefit from such resources.

Brinkley cautioned against a "knee-jerk reaction" of setting
a physical fitness standard that all firefighters must adhere
to, however.

"Everybody's always looking for that cut off," such as a
specific number of push ups or sit ups, he said.

"There are certain levels (of physical fitness) that are
benchmarks to improve to meet the demands of the job," he said,
but the specific benchmark varies from individual to individual.

"To say that every firefighter must be able to do X" is not
right, he said. "It is our position that the best way to measure
(fitness) is on an individual basis," he said.

SOURCE: http://bit.ly/1asOfa7 American Journal of
Epidemiology, online October 31, 2013.